Obesity drugs are pharma's biggest growth engine. The next phase belongs to manufacturers.

In three years, a single class of medicines has reshaped the pharmaceutical industry's league table. GLP-1 drugs, first developed for type 2 diabetes and now prescribed for weight loss, have turned one company into the industry's growth leader, put another under pricing pressure and, as patents start to lapse, opened a large opportunity for generic manufacturers. The next phase will be decided less by discovery than by price, capacity and access.

A category that rewrote a company

Eli Lilly's revenue rose 45% in 2025, to US$65.2 billion. Mounjaro, its diabetes treatment, brought in nearly US$23 billion and Zepbound, the same molecule approved for weight loss, US$13.5 billion. Growth has continued in 2026: second-quarter revenue rose 48% to US$23.0 billion, with Mounjaro up 91%. In August the company lifted its full-year guidance to US$85–87 billion, nearly double what it earned in 2024. It has also committed a further US$4.5 billion to manufacturing sites in Indiana.

Eli Lilly annual revenue

US$ billion

The incumbent's problem is price, not demand

Novo Nordisk, whose semaglutide is sold as Ozempic and Wegovy, shows the other side. Patient numbers are rising: the company reached 4.9 million people with its obesity medicines in the first half of 2026, up 69%, and its Wegovy pill, launched in the US in January, passed five million prescriptions by mid-July. Yet Novo expects its adjusted sales for 2026 to be flat to 6% lower at constant exchange rates. It points to lower realised prices from its US pricing agreement and to semaglutide patents expiring in several markets.

More patients at lower prices is what a maturing drug category looks like. It is also what creates room for new entrants.

India's generics moment

Semaglutide's patent expired in India on 20 March 2026. More than 50 brands are expected, and the first launches came in at a fraction of the originator price. Sun Pharma priced its version at about ₹3,400 a month and Dr Reddy's at about ₹4,200, against roughly ₹8,800–10,000 for Novo's product.

Monthly cost of semaglutide in India after patent expiry

Rupees per month, launch prices

India's drug makers are not stopping at home. Dr Reddy's has said it plans launches in Canada, Turkey and Brazil later this year, and India's pharmaceutical exports reached US$31 billion in 2025–26, up from US$14 billion a decade earlier. The commerce ministry has set a target of US$50 billion by 2030, and more than 60% of current exports go to tightly regulated markets such as the US and Europe.

India's pharmaceutical exports

US$ billion, financial years

The demand base is enormous

The World Health Organization estimates that 2.5 billion adults were overweight in 2022, and 890 million of them were living with obesity. In December 2025 it issued its first guideline supporting the use of medicines as part of obesity treatment for adults. Meanwhile the pipeline keeps moving: the US Food and Drug Administration approved 46 novel drugs in 2025, and Lilly has filed its oral GLP-1, orforglipron, for type 2 diabetes in the US.

Where the opportunity sits

The United States remains the largest profit pool, but one where price is now negotiated with government. Volume growth will continue; margins per patient will not.

India becomes both a domestic market and a manufacturing base for markets where patents lapse, with an advantage in cost and in plants already approved by regulators abroad.

Contract manufacturers and device suppliers sit underneath both. Injectable GLP-1s need peptide production, sterile filling and pens, and those remain the capacity constraint for originators and generic makers alike.

What this means for leaders

• For drug makers: manufacturing scale and regulatory track record are now the moat. The molecules are known; the ability to make them cheaply and reliably is not evenly spread.
• For insurers and employers: lower prices widen access, which will raise total spending before it lowers downstream costs. Budget for both effects.
• For Indian exporters: the window into regulated markets rewards quality systems more than price. A single compliance failure costs more than a year of margin.
• For food, fitness and insurance businesses: people on these medicines eat, exercise and claim differently. We look at the food side in our note on nutrition.

The science of obesity drugs is largely settled. The commercial contest that follows is about who can make them, at what price, and for whom.

Figures are as published by the sources above at the time of writing. Forecasts and company guidance are labelled as such and will change.

← Back to all insights